A 44 years old man with a congenital absence of the second permanent premolar, saving the space by keeping his second primary premolar that has now been extracted.

implant dentaire cas image de l'absence congénitale de la deuxième prémolaire A computer assisted implant planning is necessary for the immediate placement of an implant with a temporary crown.

The study shows the need for a minor vertical bone graft.

The study, illustrated here by the different colors, makes it possible to visualize the distribution of different areas of bone density and evaluate the possibility of installing a temporary crown on implant.

On this conventional 2D panoramic view, the available vertical space is evaluated. The bone in the vertical space seems abundant.

A selected vestibulo-lingual side cut reveals a significant bone atrophy in the proposed implant site, contrary to the assessment made by means of 2D panoramic. This case illustrates the lack of information associated with a plan based solely on a 2D panoramic view.

The CT scan panoramic view clearly reveals the bone deficiency area near the implant site.

The surgical guide

The surgical guide, computer designed SimPlant 3I-Safe, is checked against the stone model.

An analogue is mounted on the guides platform which has been manufactured specifically for the insertion of the implant into its final position in the mouth.

A temporary abutment is fitted on the analogue. A Duralay key is prepared to facilitate the transfer of the abutment in maintaining its proper orientation on the implant.

Pre-operative Condition

Pre-operative condition.

Open flap surgery.

Atraumatic extraction with periotome.

Surgical Operation

Drilling sequence.

Checking the borehole's depth.

The 3I-Safe system equipped with a drill stopper ensures precision and safety in this critical surgical step.

Inserting the implant through the 3I-Safe surgical guide.

High precision verification for the final adjustment of the implant.

The temporary pillar is torqued to 30 Newton / cm 2. Evaluation of the bone irregularity around the placed implant. As planned by computer, there is less than 1.5 mm of vertical bone loss.

The temporary crown is cimented. The cement surplus is removed gently. Then we apply the bone particle (connexus) to fill the minor bone deficiency.

Note: an opposed bone regeneration technique was chosen in this case.

We finish the adaptation of the flap around the temporary crown.

Panoramic view of the implant installed in the mouth with a temporary crown in one sitting, including minor bone grafting .